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Healthy plant-based diet index (hPDI) is associated with a lower risk of cardiometabolic conditions, but its association as well as interactions with microbiome have not been elucidated. We aimed to investigate the interrelations between hPDI, gut microbiome, and cardiometabolic risk markers. hPDI was derived from dietary assessments by a validated FFQ and was examined in relation to metagenomic profiles of 911 fecal samples collected from 303 men aged 71±4 y with an average BMI (in kg/m2) of 25.2±3.6 in the Men's Lifestyle Validation S